Atripla exposed high / low temperature during travel. Is it safe?

Question

Hi,

I've just came back from traveling to a tropical country and had taken two boxes of Atripla with me. One - opened, was always safe with me, stored in reasonable temperatures.

The other box, unopened, was stored in a main luggage, which has been exposed to a direct tropical sunlight for around two days (temperature in the shadow 35 C). Luggage was probably heated up quite badly. Unfortunately - later on, I stayed in an unconditioned room and stored the very same box in the fridge, which later on appeared to literally freeze fruits stored in it, therefore I think I've accidentally exposed the same box of pills for temperature of around 0 degrees Celsius for over 72 hours.

As soon as I got access to the internet I have checked storage guidelines for Atripla and they mention that it should not be stored in temps below 15 and above 30 degrees.

Is there a risk that such an exposure may have lower the effectiveness of Atripla and can it create a risk for me?

I have only 3 safely stored tablets left, and then have to either get a new box or start the one exposed to high / low temps.

Please help... Thank you so much in advance!

Answer

You are correct that the package insert states that Atripla is best stored at 25 degrees C (or 77F) with "excursions permitted to 1530 C (5986 F)." So based on the information you provided, one could not reliably vouch for the potency of the medication you have and starting a new bottle would be a reasonable conclusion.